Maternity
Maternity is a 1st season episode of House which first aired on December 7, 2004. When a newborn has a seizure and another newborn becomes ill, House believes an epidemic is spreading through the hospital. Cuddy dismisses the suggestion until other babies show up with the same symptoms. House and his team race against time to diagnose the illness, but the choices they have to make may be lethal to some of the newborns if their diagnosis is incorrect. Recap The parents of a newborn are discussing what to call her when the baby starts spitting up, even though she hasn't eaten. They call the obstetrician to examine her, and he realizes the baby is having a seizure. She is soon taken to intensive care. House is diagnosing the problems on a medical drama when Dr. Lim comes in. Dr. Lim and another doctor start talking about the fact their newborn patients both had a seizure although they were both healthy at birth. House leaves the room. He goes to intensive care and finds two babies with similar symptoms, although the first has been diagnosed with a bowel obstruction and the second with an undiagnosed fever. He thinks it is a contagious infection. Wilson thinks they have unrelated diseases, but House has an explanation for what differences that they do have and he thinks the “obstruction“ is just air. House goes to Cuddy to ask the two patients be put in isolation. Cuddy thinks the other doctors are right but House is standing by his opinion and says they have an epidemic. However, Cuddy says two sick babies don't prove an epidemic. House gets his team. They go to look at all the other babies in the maternity ward. All of the other babies are fine. However, House finds another sick baby on another floor with the same symptoms. Cuddy moves the babies with a fever to isolation and starts directing women in labor to Princeton General. There are now four sick babies, and they are getting worse - rising fever and blood pressure dropping to the point where they are unlikely to last for a day if it keeps up. They can't find anything they have in common. Cuddy goes to build a team to swab surfaces for infections. House starts to think what the disease might be. House orders two powerful narrow spectrum antibiotics for the two most likely resistant bacteria. They do an MRI on the babies, but find nothing. They start them on the antibiotics. Cameron tells the parents of Baby Boy Chen that the baby is very sick, but Foreman has to step in to tell them how bad it is. One of the parents says they had a cold, but Cameron rules it out because the child was healthy at birth. Foreman challenges Cameron about not being up front with the parents. Cameron tells Foreman it's easier to die than to watch someone die. Cuddy is still looking for the infection by swabbing surfaces. She admonishes a student for letting his tie flop around over all the surfaces, spreading any possible infection. The antibiotics are shutting down the babies' kidneys. However, they can't decide which antibiotic to discontinue because they both cause kidney damage and they still don‘t know what disease they have. House tells them to withdraw a different antibiotic from each of two patients. However, this will mean one of them is likely to die, but the one that lives will tell them how to treat the rest. His team challenges him, but House makes it clear he knows what he is doing. Cuddy and the hospital's lawyer challenge House's decision. House can't get informed consent because the parents would have to know. The number of patients is now up to six. The lawyer doesn't want to do it, but Cuddy lets House go ahead. Cameron and Foreman each tell one set of parents each that they have to discontinue one of the antibiotics. Foreman is straightforward, but Cameron is evasive. Wilson asks Cameron if she told the parent how sick the child was. He upbraids her for not preparing the parent for the worst possibility. However, she snaps back at him that it won't matter what she said if the baby does die. Cuddy is finding more contamination, but nothing related to the illness. He also sees the med student with the loose tie again and cuts it off, reminding him she warned him about it. One of the parents finds Chase and tells him she's afraid her marriage might break up if the child dies. He tells her not to get ahead of herself. At that point, one of the babies goes into distress - it‘s Baby Boy Chen. The baby goes into cardiac arrest. Chase and Foreman work hard, but can't get the heart beating again. House calls off the code blue and calls time of death. They realize that the other antibiotic, Vancomycin, is the one that will work. House tells Cameron to tell the parents. She she resists, he insists, and tells Wilson to make sure she does her job. Cameron goes to see the parents, but freezes up, leaving Wilson to tell them. They start crying. House is angry at Cameron and at Wilson for letting her get away with it. However, at that moment, Chase comes and tells them the Vancomycin isn't working either. They think it might be Vancomycin resistant staph, but it's very rare. House blames the medical profession for overprescribing antibiotics. However, then he wonders why the dead baby's blood pressure was so low before it died. The only explanation is heart damage. He sends his team home and starts an autopsy on the dead baby. The next morning, House shows the team the autopsy results - it's a heart virus. Foreman notes that there are still thousands of possibilities. However, they can't draw enough blood to test for them all. They start eliminating possibilities and getting likely candidates. Wilson starts looking for anti-viral agents that are effective against them. Even Cuddy is helping. They narrow it down to eight and get a sample from an uninfected baby as well. All the infected children are antibody positive for three viruses, but the healthy baby also tested positive for two of them. However, House realizes the healthy babies got immunity from their mother‘s antibodies. Foreman goes to take blood from the mothers. They rule out everything but Echovirus 11, a disease that only causes diarrhea and a rashin adults, but can be deadly to infants. Foreman tells the parents that the only possible treatment is experimental. Cameron lets the parents help when they change the baby's bed linen so they can be close to their newborn. House wants to speak to Foreman about how Cameron is doing. Foreman thinks she is doing fine. Foreman checks the patients - they are getting better. He and Chase give the parents the good news. House goes to see Cameron. He thinks she's had personal experience with death. He asks her where she got the idea to let the parents help with the baby. She doesn't want to talk about it and tells House he can be a real bastard. As she's leaving, she sees one of the families getting ready to leave and brightens up. Wilson finds House wondering where the virus came from. He also wonders why Cuddy didn‘t find the person who spread it as they must have been showing symptoms. He‘s also mystified by the fact that none of the babies had common personnel. However, he sees one of the volunteer women who hands out teddy bears coughing, and she also has a runny noses. He realizes all the sick babies had a teddy bear. He celebrates by watching Prescription Passion in the maternity doctor’s lounge, courtesy of the fact that the clinic patient wants him to help with her pregnancy. Clinic Patient A patient is exercising but not losing weight. House tells her she's pregnant. She thinks it's impossible because she's on a birth control implant, but House tells her it didn't take. She tells House the baby might not be her husband's. House tells her to have the baby if the ex-boyfriend looks like the husband. The woman comes back with her husband to get his blood tested for a paternity test on the pretext he might have mononucleosis. House schedules a paternity test. He realizes that she may want to have an abortion if the baby is her ex-boyfriend's. The tests show that the baby is the husband's. The patient is grateful and wants House to deliver the baby, but House wants to be done with her until he realizes he can use her as an excuse to hang out in the comfortable lounge reserved for maternity ward doctors. Major Events * Cuddy states for the first time she would be happy to pay for a psychiatrist for House if he would agree to see one. * Cameron is shown to display reluctance when it comes to telling patients bad news. * House discovers that an elderly woman volunteer at the hospital had the virus that affected the newborn babies. Title The title of the episode comes both from the fact that most of the case takes place in the maternity ward and from the case of the clinic patient. Zebra Factor 1/10 Echovirus is a common infection, and just about everyone gets it at some point during their life. It is generally only dangerous to infants. Trivia & Cultural References *House’s discussion of the responsibility of the medical profession for drug-resistant strains of bacteria is fairly accurate. For example, the spread of MRSA from hospitals to “the wild” is most likely the result of patients insisting on Vancomycin to treat common staph infections, even though most staph infections are not highly resistant and can easily be treated with penicillin or other common antibiotics. Another factor is the tendency of patients to stop taking antibiotics when they feel better, rather than finishing a complete course of treatment. Although the body is usually strong enough to fight off the infection, the surviving bacteria can spread to other patients and are more likely to be resistant to the very antibiotic used to treat the disease. *The antiviral drug used to treat the newborns is most likely Pleconaril, an experimental pharmaceutical for Picornaviruses (which include Enteroviruses like Echovirus 11). Quotes House: Starring * Hugh Laurie as Dr. Gregory House * Lisa Edelstein as Dr. Lisa Cuddy * Omar Epps as Dr. Eric Foreman * Robert Sean Leonard as Dr. James Wilson * Jennifer Morrison as Dr. Allison Cameron * Jesse Spencer as Dr. Robert Chase Links *Episode page at IMDB *Episode article at Wikipedia *Episode page at House MD Guide *Study guide at Krigline *Episode article at TV IV *Quotes at House MD Quotes *Transcript at Clinic Duty *A review of the medicine at Polite Dissent de:Nichts hilft Category:Episodes Category:Season 1 Category:Zebra Factor 1